CMS says mandating vaccines key to improvement, praises providers

The federal government's decision to mandate flu and pneumonia vaccinations for nursing home residents is a critical element in the quality improvement movement, according to the head of the Centers for Medicare & Medicaid Services.

CMS announced Friday that nursing homes will have to vaccinate their residents beginning this fall if they want to continue to receive Medicare or Medicaid funding. Residents can refuse vaccinations under the proposal.

"Improving immunization is a key element of our quality improvement strategy -- a strategy that is focused on preventing illnesses and complications in the first place," said CMS Administrator Mark McClellan. "The outstanding commitment of the nursing home industry, caregivers and other stakeholders makes clear that his commitment to better quality through more effective immunization is shared and achievable."

Federal health officials said they consulted with representatives of the American Health Care Association , the American Association of Homes and Services for the Aging, and the Centers for Disease Control and Prevention before making the decision to mandate vaccinations.

The goal is to reach a 90% vaccination level for nursing home residents. One federal study showed that in 1999, vaccination rates were just 65% for flu and 38% for pneumonia. The new rule also will encourage -- but not mandate more healthcare workers to become vaccinated. A study showed that last year, just 36% of the nursing home workforce was vaccinated.

In January, CMS raised Medicare payments for vaccinations from $8 to $18 above the cost of the vaccine.

Drug substitutions saved the government $13 million last year, but more drug substitutions under Medicare Part B would have saved an additional $6 million, the Office of Inspector General for Health and Human Services concluded in a recent report to Congress.